Aches after a marathon, ultra or long event: what is normal and what is not
What soreness is normal after long events, what helps recovery, and the warning signs of a medical problem or injury that should not be ignored.
After a marathon, ultra or similar long event, most people have sore, stiff muscles for several days. That is the normal consequence of prolonged effort and the muscle soreness that follows unaccustomed loads. Reviews of ultra trail running and endurance events also describe musculoskeletal injuries and some medical problems, so it helps to know the difference.
When to get urgent help
Call 999 or go to A&E straight away if you have any of these after a long event. Do not drive yourself.
- Confusion, collapse, or a seizure
- Chest pain, severe breathlessness or a very fast or irregular heartbeat
- A severe headache with repeated vomiting
- Severe muscle pain and swelling with very dark (tea-coloured) urine, or passing little or no urine
What it can feel like
- Sore, stiff, heavy legs that peak 1 to 3 days after the event, and ease over the following days
- Tiredness, a flat feeling, and disrupted sleep for several days
- Blisters, chafing and sore feet
- Lower-limb aches in the knees, hips, Achilles or feet, which are the most commonly reported injuries according to a 2026 review
Common contributors
- Muscle soreness follows long events, and it peaks a day or two later
- A 2026 narrative review of ultra trail running reports that musculoskeletal injuries, particularly of the lower limbs, are the most frequent, often from overuse, inadequate recovery or suboptimal training adaptation
- The same reviews describe less common but more serious problems, such as acute kidney injury, gastrointestinal upset and low blood sodium (exercise-associated hyponatraemia) in prolonged events
General self-care
These are general comfort measures many people find reasonable. They are not a treatment plan, and what suits one person may not suit another.
- Walk, swim or cycle gently in the first days, and rest when you need to. A Cochrane review found stretching does not meaningfully reduce muscle soreness
- Eat and drink normally, rehydrate sensibly, and sleep well. Avoid drinking large volumes of plain water in a short time
- Look after blisters, keep them clean, and see a doctor if they look infected
- Return to running only once everyday movement is comfortable, and build back gradually
- If you use over-the-counter pain relief, follow the packet instructions, and ask a pharmacist, as some medicines are best avoided after prolonged effort or if you are dehydrated
When to see your GP
See your GP promptly, or call NHS 111, if you have any of the following:
- Pain in one spot on a bone that is getting worse, or being unable to put weight on a leg
- A painful, swollen, warm calf
- A hot, red, swollen joint, or an infected-looking blister
- Soreness that is getting worse after a week instead of easing
Consider seeing your GP if:
- Call 999 for confusion, collapse, a seizure, chest pain, severe breathlessness, or a severe headache with vomiting
- Severe muscle pain and swelling, marked weakness, very dark (tea-coloured) urine, or passing little or no urine. This needs urgent medical attention
- Pain in one spot on a bone that is getting worse, or being unable to put weight on a leg. This can be a stress fracture
- A painful, swollen, warm calf, a hot red swollen joint, or soreness that is getting worse after a week instead of easing
How osteopathy may help
Osteopaths regularly see people with muscle soreness and minor sports injuries after endurance events. After taking a full history and examining you, treatment typically combines hands-on techniques (such as soft-tissue work, joint mobilisation and, where suitable, manipulation) with advice and exercises you can do yourself. For some people this may help ease pain and stiffness and make movement more comfortable.
Research on hands-on treatment for recovery after endurance events is limited. Time, sleep, food, gentle movement and a gradual return are the best-supported approach, and I would see treatment as a way to feel more comfortable and to check that a niggle is not something more.
Results vary from person to person, some people feel a little sore for a day or two afterwards, and osteopathic care is not right for everyone. It sits alongside, not instead of, medical care, and staying active and doing your exercises remain central.
If you would like your symptoms assessed, you are welcome to book an appointment. Osteopathic care is not right for everyone, and if something needs medical attention first, I will tell you.
Common questions
How long does it take to recover from a marathon?
Soreness commonly peaks a day or two afterwards and then eases over the following days, but it varies a lot from person to person and with the type of event. Hard training should wait until everyday movement is comfortable. If something is getting worse after a week instead of easing, get it checked.
Is dark urine after a long race a worry?
It can be. Very dark (tea-coloured) urine, or passing little urine, together with severe muscle pain and swelling after very intense exercise needs urgent medical attention.
Does stretching help sore legs after a marathon?
A Cochrane review found stretching before or after exercise does not produce clinically important reductions in muscle soreness. Gentle walking, sleep and time work better.
Sources and further reading
Links open in a new tab. Sources were checked in October 2026.
- Basile et al., Journal of Back and Musculoskeletal Rehabilitation 2026: Epidemiology of injuries and illnesses in ultra trail running, narrative review
- Golubjatnikov and Walker, Emergency Medicine Clinics of North America 2024: Endurance sporting events
- Cochrane review (Herbert et al., 2011): Stretching to prevent or reduce muscle soreness after exercise
Related guides
This page is general information to help you understand common aches and pains. It is not medical advice and cannot diagnose your problem. If you are worried about your symptoms, please speak to your GP or call NHS 111.